Pro-Transition Doctors Admit Risks of Altering Hormones

Doctor with patient
Doctor with patient | Image by sheff/Shutterstock

Doctors at the World Professional Association for Transgender Health admitted hormone inhibitors have irreversible side effects on minors, such as infertility, bone loss, and hindered brain development, according to a news report.

World Professional Association for Transgender Health (WPATH) educational sessions from September 2022, published Tuesday by the Daily Caller, revealed physicians expressing extensive concerns about hormone inhibitors. The meeting was part of a “transgender medical certification program” for WPATH-licensed doctors. The group is a leading advocate for allowing transgender procedures for minors.

Dr. Scott Leibowitz, a board of directors member for WPATH and a co-lead in the development of the “Standards of Care” for WPATH’s adolescent chapter, admitted the media has downplayed concerns about “puberty blockers.”

“I think when we just say, ‘Oh, puberty blockers are just reversible, and it’s a very noninvasive treatment,’ I would say it’s more invasive than oftentimes the media makes it out to be or other people,” he said.

Dr. Daniel Metzger, a WPATH-certified pediatric endocrinologist, said during a session titled “Foundations in Gender Affirming Hormone Therapy: Adults and Adolescents” that hormone inhibitors prevent adolescents from storing necessary calcium levels.

“Normally puberty is the time of putting the calcium into your piggy bank. This is how I explain it to families. You’ve got a piggy bank for your calcium, and you better get it all in by 25 because, at 25, you’re going to live off that piggy bank,” he said.

“The puberty blockers slow that calcium accrual back into the bones quite a bit, back to the prepubertal level. We do know that even if you look at people now age 22, if you’ve done all of this and you’ve gone off and then you go back on the hormones that you want to have, you have not caught up by age 22. Which is about the time you need to fill up your piggy bank. This is a concern that not everybody is getting their piggy bank completely filled up with calcium,” he continued.

The statements appear to contradict WPATH’s own Standards of Care, which recommend children with gender dysphoria receive hormone inhibitors, cross-sex hormones, and sex alteration surgeries. The group claims hormone inhibitors are “fully reversible” and recommends they be prescribed at the first signs of puberty.

Metzger continued to note that there is not enough information on the impact of hormone inhibitors on brain development.

“Obviously teenagers, their brains are changing. They’re unwiring, they’re rewiring. And if we’ve started one kid unwiring and half rewiring, and then we changed their puberty the other way, and we’re unwiring, people have been trying to figure out what this does for kids’ brains,” he said.

“They seem to do reasonably the same as their friends, but we’re not looking at their IQ and their learning ability and lots of other things,” he continued.

Fertility was another area of concern for Metzger, who said hormone inhibitors stop developing boys from producing sperm and may prevent girls from maturing their eggs for fertility preservation.

“Kids have zero idea about their fertility,” he said.

Leibowitz noted that hormone inhibitors disrupt essential brain and bone development.

“There’s challenges with puberty suppression that we have to acknowledge, and that’s why it’s ‘reversible asterisks,'” he said. “One cannot be on puberty suppression endlessly. You get to a place where physiologically, we need hormones.”

Medical evidence, Leibowitz said, should not be the only consideration from doctors, who he believes should also consider the ethics of providing treatment.

“Regardless of the evidence base, as I said, evidence is one part of this; there is an ethical human rights component to treating people. We don’t rely on evidence for every single treatment we do in medicine,” he said.

“We have to look at the whole thing. Ethics, human rights, justice for trans people,” he continued.

Metzger went as far as to note that early use of hormone inhibitors in boys may hinder the development of their genital tissue necessary to create a surgical vagina in a later sex alteration surgery, should they decide to transition genders as an adult.

“When you think about vaginoplasty, the creation of a vagina in an assigned male, you need tissue, genital tissue, to create that vagina. And if we are taking an 11-year-old boy, who does not have a lot of genital tissue and blocking puberty right there, we’re preventing the growth of the vagina for down the road,” he said.

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